This presentation reviews current status of chemotherapy for advanced disease and adjuvant chemotherapy.
Advanced Disease : protracted continuous intravenous infusion of low doses (200-300mg/m²/d) of 5-fluorouracil (5FU) has obtained response rates >30% and biochemical modulation using a combination consisting of 5FU plus leukovorin (LV) has shown reponse rates >40%, in addition, a combination consisting of 5FU plus interferon- α has also obtained response rates >30%.
However.most studies employed these regimens have failed to shown significant prolongation of survival time compared to 5FU alone.
Adjuvant Chemotherapy : A combination consisting of 5FU and levmnizole has recognized to be a standard adjuvant regimen for Dukes C. Recently prospective randomized trials comparing 5FU plus LV versus control reported significant improvement of disease free survival and overall survival in 5FU plus LV arm.
A combination regimen consisting of Methgl CCNU, oncovin and 5FU(MOF) has escalated 3 year survival rate of rectal cancer compared to control or irradiation. Thus this treatment has considered to be the first chonce at present time but confirmatory studies are in progress.